TRH's puberty; 4.8 Flashcards
What is the pattern of Hypothalamic-Pituitary-Gonadal (HPG) axis activity from birth to puberty?
Born → active, but ineffective, HPG (6-8wks) → suppressed (years) → suppression released → active and effective HPG
What is adrenarche?
Adrenarche, AKA pubarche, is pubic hair growth
What causes adrenache/pubarche?
Development of the adrenal zone reticularis → androstenedione and DHEA
What is thelarche?
Breast development
What causes thelarche?
Increasing estrogens
What is gonadoarche?
Production of ovarian hormones and mature gametes
What is Gonadotropin Dependent Precocious Puberty (GDPP)?
“True” precocious puberty
What causes GDPP?
Idiopathic (80%) CNS related (20%)
How is GDPP diagnosed?
GnRH analog stimulation test…gonadotropin levels are induced by GnRH stimulation
(Does NOT happen with GIPP)
What is the best test for Central Precocious Puberty (CPP)?
LH < 0.1 → prepubertal
LH > 0.3 → pubertal
What is Gonadotropin Independent Precocious Puberty (GIPP)?
“False alarm”
What causes GIPP in girls?
Ovarian cysts
Ovarian tumors
What causes GIPP in boys?
Leydig cell tumors
hCG secreting germ cell tumors
Familial male-limited precocious puberty
What is familial male-limited precocious puberty caused by?
Activating mutation of LH receptor
What are the signs and symptoms of GIPP?
One or two signs of puberty, but not all…and not staged similarly
Display adrenarche
Bone age > actual age AND adrenarche in boys and thelarche in girls
